Oral Immunotherapy OIT Up-Dosing

Oral Immunotherapy (OIT) Up-Dosing Pause?

What has led to my decision to take a break from Sosi’s peanut Oral-Immunotherapy (OIT) Up-Dosing? Well, there are a few key factors : reactions, skin testing, and my anxieties around a new school and routine.

A few weeks ago, a lot happened within a 5 day period of time. Starting us off was Sosi’s yearly skin test with her regular allergist. The results were similar to last year, which was disappointing. I try not to get my hopes up around those little red blotches, but it is hard not to hope. Sosi’s skin test readings were 5mm for milk and 11mm for peanuts. These numbers indicated a need for blood-work to help us decide the next best steps for continuing the milk ladder. So skin scratch test and blood-work all in one day, no fun.

After disheartening skin test results, a lip reaction, and a new school schedule with new situations involving trusting new adults to keep Sosi Safe, this food allergy mama is tired, and needing to slow down.


Since switching to actual peanuts, Sosi has reacted to some doses. The reactions happen fast, with no real warning, which makes it really hard for me to stay calm. Hearing Sosi say, “Mama, my lip is itchy and puffy,” just hollows my heart and drops a quick punch right into the pit my stomach. Watching your little girl’s lip go from, “normal,” to swollen is alarming, even when I know the facts. Her lip reactions are due to little cuts on the skin. These cuts often occur in younger Oral Immunotherapy patients as the winter months roll in, and lips start to crack. Thankfully this type of reaction is equivalent to a skin prick test, which is not systemic.

OIT oral immunotherapy treatment information for food allergy families
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OIT Safety Guidelines

Something important to note is the strict rules surrounding each dose. Sosi is not allowed to be physically active, or elevate her heart rate for one hour before her dose, as well as two hours after. As you can imagine, this requires some creative daily scheduling and planning to occupy this busy toddler without relying solely on technology. Baths are also a no since the body temperature increases which could cause a reaction, so another activity we have to carefully factor in each day.

I prefer to up-dose in the morning because the rest hour before the dose has already been honoured. However that leaves us two hours after, which is a tight squeeze before school starts in the morning.

Next steps for Oral Immunotherapy (OIT) Up-dosing?

So, where do we go from here with Sosi’s Oral Immunotherapy (OIT) Up-dosing ? Thankfully our allergists are all very understanding and openly accept our plans to pause the up-dosing. We are two appointments shy of completing the daily goal of 2.0 grams of peanut. Currently Sosi’s daily dose is 0.50 grams of peanut (which is roughly half of a peanut). It really is a large chunk of peanut, and we are thankful to have come this far over the past 12 months.

Even though we are taking a break, I completely acknowledge how far Sosi has come. We lived in fear of a crumb of peanut, and now we go to public places and I only insist on complete strangers using our hand wipes 50% of the time.

Mel 🙂

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